<form id="user-profile-form" class="form-horizontal js-ajax-form" method="post" action="{:U('Teacher/Center/tixian_post')}">
   <div class="panel-body">
	    <div class="form-group">
			<label class="col-md-2 control-label">提现金额</label>
			<div class="col-md-7 controls">
			    <input type="text"  name="money" placeholder="最低提现金额100元！" class="form-control">
			</div>
		</div>
		<div class="form-group">
			<label class="col-md-2 control-label">真是姓名</label>
			<div class="col-md-7 controls">
			    <input type="text"  name="turename" placeholder="和账户名保持一致！" class="form-control">
			</div>
		</div>
		<div class="form-group">
			<label class="col-md-2 control-label">账户账号</label>
			<div class="col-md-7 controls">
			    <input type="text" name="count" placeholder="支付宝账户" class="form-control">
			</div>
		</div>
   </div>
   <div class="modal-footer">
      <button id="join-course-btn" class="btn btn-primary js-ajax-submit"   type="submit" >提交</button>
      <a href="#" class="btn" data-dismiss="modal">取消</a>
   </div>
</form>	
<tc_include file="Public:scripts" />          